Question

A patient is admitted to the emergency department with chest pain. An electrocardiogram shows changes consistent with an evolving myocardial infarction. The patient's cardiac enzymes are pending. The nurse caring for this patient will expect to:

a. administer aspirin when cardiac enzymes are completed.
b. give alteplase [Activase] within 2 hours.
c. give tenecteplase [TNKase] immediately.
d. obtain an order for an INR.

Answer 1

In the case of an evolving myocardial infarction, the nurse should administer tenecteplase [TNKase] immediately, without waiting for cardiac enzyme results, as part of the emergency response to dissolve clots.

Step-by-step explanation:

When a patient is admitted to the emergency department with chest pain and an electrocardiogram indicates an evolving myocardial infarction (MI), it is critical to administer immediate treatments. These treatments include administering supplemental oxygen, aspirin to help break up clots, and nitroglycerine sublingually for quick absorption.

Since thrombolytic agents are essential in dissolving clots and improving prognosis, the nurse would expect to administer a thrombolytic agent as soon as possible. In this scenario, the best option is to give tenecteplase [TNKase] immediately, as it is one of the thrombolytic agents used for treatment of MI.

Waiting for cardiac enzymes like creatine kinase MB and cardiac troponin, which are indicative of MI, should not delay the administration of thrombolytic therapy.